# Psychometric Properties of the Teleprimary Care Oral Health Clinical Information System (TPC-OHCIS) Questionnaire Using the Rasch Model

## TL;DR

This study evaluates the reliability and validity of a questionnaire used to assess a digital healthcare system in Malaysia, finding it effective for monitoring implementation.

## Contribution

The study validates the TPC-OHCIS questionnaire using the Rasch model, demonstrating its suitability for evaluating digital healthcare implementation.

## Key findings

- The questionnaire showed high reliability with a Cronbach alpha of 0.93 and excellent person and item reliability.
- Unidimensionality was confirmed, with over 40% raw variance explained by measures.
- After deleting 18 items, the questionnaire was deemed fit for use in monitoring digital healthcare implementation.

## Abstract

Background

The Tele Primary Care Oral Health Clinical Information System (TPC-OHCIS) was implemented in Malaysia to digitalize health care and reduce numerous ground-level manual tasks. This study measures the psychometric properties of the TPC-OHCIS questionnaire among healthcare workers (HCWs) at primary healthcare clinics (PHC).

Method

A pilot study was conducted at PHC, which implemented the TPC-OHCIS application for service delivery. The questionnaire contained 65 items with four response categories, grouped into four scales: technology, organization, external support, and human resource. The questionnaire items were analyzed using the Rasch model in Winsteps 3.72.3.

Results

There were 319 respondents who participated (98.8%). The Cronbach alpha was 0.93. The construct validity was determined by a positive point measure correlation (PMC) value, with an infit and outfit mean square (MNSQ) range of 0.4-1.5 and a Z-standardized (ZSTD) range of -2.0 to 2.0. The person and item reliability were 0.93 and 0.97, respectively, indicating excellent reliability. The questionnaire was unidimensional, where the raw variance explained by measures was >40%.

Conclusion

The questionnaire was deemed fit for an actual survey after 18 items had been deleted. It has good psychometric properties and is practically applicable for evaluating HCWs on the TPC-OHCIS application implementation process monitoring using the local Malay language. High reliability and unidimensionality were achieved, supporting its use in digital healthcare. With this validated questionnaire, it will enhance digital healthcare implementation and streamline manual tasks.